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metronidazole-drug-study

Generic Name: Metronidazole
Brand Name: Flagyl, Metric 21, Noritade, Protostat,MetroGel-Vaginal
Classification: Antibiotic, Antibacterial, Amebicide, Antiprotozoal

Patients Dose:
Metronidazole 500mg1 tab TID PO

Minimum Dose:
PO : 250mg TID IV : 100mg /mL

Maximum Dose:
PO : 750 mg TID 6-10days IV :100mg/mL

Availability: 
Capsules: 375 mg
Injection: 5mg/mL
Oral suspension: 200mg/5ml
Tablets: 200mg, 250mg, 400mg, 500mg
Topical gel: 0.75 %,1%

Routes of Administration
PO, IV, Topical

Pharmacologic Class:
Nitroimidazole

Therapeutic Class:
Antibacterial Antiprotozoal

Pharmacokinetics Onset:
PO: uknown IV:immediate Topical: unknown

Peak
PO: 1-2 hrs IV:immediate Topical: 6-10hrs

Duration:
PO, IV, Topical:unknown

Therapeutic Effects:
Hinders growth of selected organisms, including most anaerobic bacteria and protozoa

General Indications

  • Amoebic hepatic abscess
  • Intestinal amebiasis
  • Trichomoniasis
  • Retractory trichomoniasis
  • Bacterial infection caused by anaerobic microorganisms
  • To prevent postoperative infection in contaminated colorectal surgery
  • Pelvic inflammatory disease

Contraindications 

  •  Contraindicated with hypersensitivity to metronidazole; pregnancy (do not use for trichomoniasis in first trimester).
  • Use cautiously with CNS diseases, hepatic disease, candidiasis (moniliasis), blood dyscrasias, lactation.

Adverse Effects

  • Headache, dizziness, ataxia, vertigo, incoordination, insomnia, seizures, peripheral neuropathy, fatigue
  • Unpleasant metallic taste, anorexia, nausea, vomiting, diarrhea, GI upset, cramps
  • Dysuria, incontinence, darkening of the urine
  • Thrombophlebitis (IV); redness, burning, dryness, and skin irritation (topical)
  • Severe, disulfiram-like interaction with alcohol, candidiasis (superinfection)

Nursing Responsibilities

Before

  • Assess pt. Infection
  • Watch carefully for edema because it may cause sodium retention
  • Assess skin for severity areas of local adverse reactions
  • Record number and character of stools
  • Assess pt.’s and family’s knowledge of drug therapy

During

  • Give drug with meals to minimize GI distress
  • To treat trichomoniasis, give drug for 7 days instead of 2-g single dose
  • Use only after T.vaginalis has been confirmed by wet smear
  • Tablets may be crushed for pt’s. with difficult swallowing
  • Do not use aluminium needles or hubs, color will turn orange/rust

After

  • Tell pt. that metallic taste and dark or red brown urine may occur
  • Instruct pt. to take oral form with meals to minimize reactions
  • Instruct to complete full course of therapy
  • Tell pt. not to use alcohol or drugs that contain alcohol.
  • May cause dizziness/ light headedness

Reference:

  • Nursing 2008 Drug Handbook: Lippincott Williams & Wilkins
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